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Botulinum Toxin Market Size, Share & COVID-19 Impact Analysis, By Application {Therapeutic (Chronic Migraine, Spasticity, Overactive Bladder, Cervical Dystonia, Blepharospasm, and Others) and Aesthetics (Forehead Wrinkles, Glabellar Lines, Crow’s Feet, and Others}, By Type (Botulinum Toxin Type A and Botulinum Toxin Type B), By End-user (Specialty & Dermatology Clinics, Hospitals & Clinics, and Others), and Regional Forecast, 2022-2029

Region : Global | Format: PDF | Report ID: FBI100996



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The global botulinum toxin market size was valued at USD 6.13 billion in 2021. The market is projected to grow from USD 6.50 billion in 2022 to USD 9.09 billion by 2029, exhibiting a CAGR of 4.9% during the forecast period. The global COVID-19 pandemic has been unprecedented and staggering, with botulinum toxin experiencing lower-than-anticipated demand across all regions compared to pre-pandemic levels. Based on our analysis, the global market exhibited a decline of -32.6% in 2020 as compared to 2019.

Botulinum toxin is a neurotoxin produced by Clostridium botulinum, which is a gram-positive anaerobic bacterium. The product can be broken into seven neurotoxins, which are antigenically and serologically different but are structurally similar. Type A and B are the currently only commercially available forms in the market. These products are currently used for the management of a wide variety of medical conditions and aesthetic procedures.

There has been a high demand for these non-invasive cosmetic procedures in the current scenario. New product launches, increasing affordability, and amendments in reimbursement policies to cover these products for therapeutic use drive the market's growth. In response to this positive growth trend, leading players in this market are focusing on constant innovation and upgrades of their product portfolio for better aesthetic and improved patient therapeutic outcomes. For instance, in April 2022, AbbVie Inc. conducted a clinical trial to evaluate the safety and efficacy of botulinum toxin type A (AGN-151607) injections to prevent post-operative atrial fibrillation in patients who undergo open-chest cardiac surgery.

Moreover, with the increasing importance and demand for aesthetic beauty, coupled with the increase in disposable income globally, the usage of these products has risen. Initiatives by key players in terms of new product launches to cater to the demand are also likely to drive the global botulinum toxin market growth during the forecast period.


Decline in Demand for Cosmetic Procedures during Pandemic Negatively Impacted Market

COVID-19 pandemic had a significant impact on the healthcare sector, as it was the core of this global pandemic. It negatively impacted the market. A key factor which led to the negative impact was the decrease in the adoption of cosmetic procedures amongst individuals. The closure of dermatology clinics due to lockdown and the fear of contracting the virus among individuals led to a lower number of procedures. Furthermore, implementation of COVID-19 protocols such as social distancing and cancellation of elective procedures by regulatory authorities also contributed toward the decline of the market. For example, according to the International Society of Aesthetic Plastic Surgery (ISAPS), a decline of 0.9% was witnessed in the number of these procedures across the globe.

Major players in the market reported a decline in the revenue from neurotoxin preparations in the 2020 financial year. For instance, AbbVie Inc., a leading player in the market, recorded a decrease of 33.1% in their 2020 revenue compared to last year for ‘BOTOX Cosmetic’ and ‘BOTOX Therapeutic,’ respectively. Other companies such as Ipsen Pharma have also reported a decline in revenues of these products in 2020 owing to the closure of treatment centers. In 2021, the global market witnessed a recovery as dermatology clinics reopened and people again started opting for these procedures. In addition, during the lockdown, people became more conscious about their appearances, which also contributed positively toward the increasing procedure volume. Major companies such as AbbVie Inc. and Ipsen Pharma witnessed a growth in their aesthetics portfolio as a surge in demand for their products was witnessed globally. For instance, Ipsen Pharma accounted for USD 517.4 million in 2021 for their product Dysport compared to USD 420.5 million in 2020. Similarly, due to increase in brand investment and strong recovery from COVID-19, AbbVie Inc. also witnessed an increase of 87.4% in their revenue earned from the sales of their BOTOX portfolio globally compared to 2020.


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Increasing Awareness through Promotional Activities by Key Players to Boost Product Adoption

Key players in this market have adopted new and improved marketing strategies to increase the global demand for these products among customers. Major players such as AbbVie Inc. and Merz Pharma are adopting marketing techniques to create awareness among customers. For example, in September 2020, Merz Aesthetics casted Gwyneth Paltrow as a spokesperson for Xeomin, a botulinum toxin product. The actress will aid in terms of increasing the product’s customer base, as these celebrities are mostly followed by people on social media, thus leading to the rising demand for these products. For instance, in August 2022, Merz Aesthetics announced that Joe Jonas will be the latest brand partner of Xeomin. The partnership with Joe Jonas started as a “Beauty on Your Terms” campaign for the product, specifically for the U.S. customers. Similarly, in January 2019, Allergan plc (AbbVie Inc.) launched a direct-to-customer campaign “Own Your Look” to address the common misconceptions related to these products and encourage people to make their choices.

Promotional activities by market players using social media platforms such as Instagram and Facebook are also becoming an essential tool of marketing. According to several cosmetic surgeons, patients across the globe have urged them for procedures which makes them more like software filtered themselves. Therefore, initiatives by these major companies to engage with customers by casting celebrities to endorse their products and launch campaigns to address the concerns of common people will lead to the growth of the market in the forecast period.


Surge in Demand for Non-Invasive Procedures to Boost Market Expansion

The global demand for non-invasive and minimally invasive procedures has surged in the past few years. According to the International Society of Aesthetic and Plastic Surgery (ISAPS), the total number of non-surgical procedures which include botulinum toxin, hyaluronic acid, and laser hair removal was estimated to be 14,400,347 in 2020. The total number of non-surgical procedures increased by 5.7% compared to the previous year.

Furthermore, according to the report published by the International Society of Aesthetic Plastic Surgery (ISAPS), the adoption of these procedures in 2020 also increased by 26.0% since 2016. The growth in the number of procedures is due to the sudden shift in people looking for easy, pain-free methods to appear youthful and healthy without facing the problems associated with invasive cosmetic surgeries. The growing demand for these procedures have also led the manufacturers and suppliers of non-invasive cosmetic technology to focus toward these products. Due to which, major players have started working toward launching advanced products in the market by either applying for a regulatory approval or focusing toward R&D activities. For example, in June 2021, GALDERMA announced that Alluzience completed its European decentralized procedure with a positive decision to be used as the first ready to use neuromodulator to improve moderate to severe glabellar lines among patients in the region.

Increasing R&D Initiatives for Expansion of Therapeutic and Aesthetic Applications to Fuel Market Growth

The products are used for both therapeutic as well as aesthetic indications. The dual applicability of the product leads to the rise in demand for botulinum toxin amongst individuals, thus driving the growth of the market. The increasing prevalence of critical and chronic diseases such as spasticity, cervical dystonia, and chronic migraine also fuels the market growth. For instance, according to an article published by Johns Hopkins Medicine, in 2020, over 12 million people worldwide are affected by spasticity, which includes 80.0% people suffering from cerebral spasticity and 80.0% of people suffering from multiple sclerosis. Growth in research and development initiatives by major pharmaceutical companies to provide treatment options for such critical diseases also leads to market growth.

Apart from therapeutic applications, the products have regulatory approvals to treat aesthetic indications including forehead lines, crow’s feet, and frown lines. Ongoing clinical trials by key industry players to expand the aesthetic use of their existing products drives the growth of the global market. For example, in July 2022, Evolus, Inc. announced that the company has completed patient enrollment for the Phase II clinical study which evaluates the “extra strength” dose of Jeuveau.


Availability of Counterfeit Products to Restrain Market Growth

In the past decade, these products established a significant position in the global market due to the dual applicability of these products in therapeutics as well as cosmetic procedures. Over the years, the product has proven to be therapeutically beneficial for children suffering from conditions, including cerebral palsy and adults suffering from stroke-related conditions. Along with therapeutics the cosmetic application of these products is also increasing. However, as the demand for these products surges, the availability of counterfeit products to cater to the increasing demand also increases. The entry of the counterfeit products in the market was seen after the branded products were generalized. Use of illegal products by beauticians and demand for cheap products by customers online have inflicted harm on several individuals.

Counterfeit products duplicate genuine brands by using the same packaging and trademarks. This helps them dupe the customers with lower prices that they offer. However, the products are unregulated and manufactured illegally, proving harmful to consumers due to their side effects. To safeguard people from these fake products, the U.S. FDA has also issued several warnings regarding these products. Across the globe, several instances have also been reported where the respective regulatory bodies have seized shipments of counterfeit products to regulate the problem. For example, in July 2020, the U.S. Custom and Border Protection (CBP) officers at Cincinnati express consignment facility seized multiple packages of counterfeit injections. The increasing availability of fake products with lower prices might restrain the growth of genuine products as consumers may prefer these products due to lower costs and thus disrupt the revenue of major companies.


By Application Analysis

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Multiple Product Launches in Therapeutics Leads to the Segment’s Dominance in 2021

Based on application, the global market is segmented into therapeutics and aesthetics. The therapeutics segment is further sub-segmented into chronic migraine, spasticity, overactive bladder, cervical dystonia, blepharospasm, and others.

The therapeutics segment dominated the global botulinum toxin market share in 2021. Key players are investing heavily in R&D initiatives to launch products and are focused on getting regulatory approvals for the treatment of diverse diseases. For instance, in February 2022, Lanzhou Institute of Biological Products Co., Ltd. started a clinical trial to evaluate the safety and efficacy of Hengli (Chinese Botulinum Toxin type A) for the treatment of patients with overactive bladder.

The growth of the segment can also be attributed to the increasing prevalence of chronic diseases globally. For instance, in the therapeutics segment, spasticity holds the largest market share. The increased prevalence of multiple sclerosis worldwide is one of the critical reasons for spasticity. For instance, according to an article by the NCBI, in 2020, the prevalence of multiple sclerosis is 2.8 million globally. Similarly, chronic migraine is the second largest sub-segment. The strong global prevalence of this disease fuels its growth. For instance, according to a report published by The Migraine Trust, in 2020 approximately 10 million people in the U.K. are living with migraine.

Furthermore, according to a published article, in 2022 the estimated prevalence of cervical dystonia ranges from 5 to 30 cases per 100,000 individuals. The segment is expected to show steady growth prospects in the forecast period.

On the other hand, the increasing demand for minimally invasive procedures and the growing awareness among individuals regarding the use of these products for aesthetic application are likely to drive the growth of the market. For instance, according to the International Society of Aesthetic Plastic Surgery (ISAPS), in 2020, about 6,213,859 botulinum toxin procedures were done globally. Furthermore, a significant number of product launches in this segment is also expected to fuel the market growth.

By Type Analysis

Backed by a Large Number of Product Approvals, Type A to Dominate the Market

On the basis of type, the market can be segmented into botulinum toxin type A and botulinum toxin type B. The type A segment held a dominant market share in 2021. The segment is expected to grow with the highest CAGR in the forecast period. The dominance of the segment can be attributable to the significant number of product launches. Furthermore, continuous efforts by major players to launch new and advanced type A products also contribute positively toward segment growth. For instance, in April 2021, Aquavit LLC and its manufacturing partner Huons bio Pharma announced that they completed the acquisition of an exclusive license to register, market, and commercialize a botulinum toxin candidate (DTX-021) in the U.S. and Canada.

Moreover, type A injection is the most common cosmetic procedure performed globally. Surveys from core specialty organizations consistently rank it first on the list of member-reported, non-surgical procedures.

The type B segment is anticipated to expand at a slower growth rate during the forecast period owing to limited product launches and significantly less clinical trials being conducted on these products. However, the focus of key stakeholders to expand the therapeutic applications of Myobloc post its strategic acquisition by Supernus Pharmaceuticals, Inc. from the U.S. Worldmeds LLC (USWM, LLC) will contribute toward the segment’s growth.

By End-user Analysis

Prevalence of Aesthetic Problems Globally Enables the Segment’s Dominance

Based on end-user, the market is segmented into specialty & dermatology clinics, hospitals & clinics, and others. The specialty & dermatology clinics segment accounts for the largest share of the market. A significant proportion of these procedures is being conducted in these clinics in comparison to hospitals. This is one of the major factors accounting for the segment’s growth. The growing prevalence of aesthetic problems such as frown lines, glabellar lines, and crow’s feet is also expected to favor the segment's expansion.

On the other hand, the hospitals & clinics segment accounted for the second largest market share in 2021. Strong procedural volumes for aesthetic and therapeutic applications being conducted in hospitals and clinics also leads to the segment’s growth. For instance, according to the American Society for Aesthetic Plastic Surgery, out of 6,271,488 botulinum toxin procedures conducted worldwide in 2019, around 40.0% of them were performed in hospitals.

The others segment is expected to grow at a slower rate due to the lower presence of skilled professionals in these settings.


North America Botulinum Toxin Market Size, 2021 (USD Billion)

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On the basis of region, the global market is studied across North America, Europe, Asia Pacific, Latin America, and the Middle East & Africa.

The North America region can be further segmented into the U.S. and Canada. The North America market accounts for the highest share and has reported a revenue of USD 4.04 billion in 2021. Increasing number of product launches, presence of major companies, and the growing adoption of these procedures among people in the region are the factors that contribute toward the region’s growth. For instance, according to the International Society of Aesthetic Plastic Surgery, in 2020, about 1,477,000 botulinum toxin procedures were performed in the U.S. Surge in the number of product launches due to increasing regulatory approvals for therapeutic applications of these products also contributes positively toward the region’s growth.

Europe captured the second-largest market share, which is attributable to the growing preference for these procedures amongst individuals in key European countries. Furthermore, the rising expenditure on R&D initiatives to launch new products is also one of the major factors for the growth of the European region. For instance, according to the International Society of Aesthetic Plastic Surgery (ISAPS), 397,512 nonsurgical cosmetic procedures were performed in 2020 in Spain, of which 100,296 were these procedures.

The Asia Pacific region is estimated to grow at a high CAGR compared to other regions. Recent product approvals and multiple product launches are anticipated to fuel the market growth. For example, in June 2021, Merz Therapeutics and Teijin Pharma Limited announced that Japan’s Ministry of Health, Labor and Welfare (MHLW) granted additional approval to market Xeomin for intramuscular injections for the treatment of adult lower limb spasticity.

The increasing procedure volume in key Latin American countries like Brazil will contribute toward the region’s growth. The increasing trends in terms of adoption of these products for aesthetic procedures in the region and the growing awareness among people also contributes to the market growth. In the Middle East & Africa, the number of these procedures are estimated to witness an increase. Growing per capita spending on healthcare and increasing health and beauty standards is also estimated to lead to the growth of these regions in the forecast period. For instance, according to the latest study by the International Society of Aesthetic Plastic Surgery (ISAPS), the total number of nonsurgical procedures in Brazil in 2020 were accounted to be 622,396 out of which these procedures were 334,220.


Strong Product Offerings and Global Reach to Enable AbbVie Inc. & Ipsen Pharma to Reach Market Dominance

In terms of competitive landscape, the market has diverse market players, with companies ranging from large, established players to small and emerging regional players. In terms of the present market scenario, AbbVie Inc. dominates the market and accounts for a substantial proportion of the market. The company dominates the market due to a strong product portfolio comprising both BOTOX Cosmetic and BOTOX Therapeutic. The diverse applications of the company’s product portfolio, coupled with consistent efforts by the company to engage in clinical trials also fuels the company’s growth. For instance, in February 2021, the U.S. FDA granted approval to AbbVie Inc.'s Onabotulinumtoxin A in treatment of detrusor overactivity in pediatric patients of age 5 or above. This Onabotulinumtoxin had regulatory approval for the treatment of adult’s detrusor activity previously.

Companies like Ipsen Pharma and Merz Pharma are engaged in strategic initiatives like new product launches and are focused on getting regulatory approvals to launch their products across the globe. For instance, in August 2021, Merz Pharma received approval for the use of XEOMIN in Europe for the treatment of chronic sialorrhea in children and adolescents (2 to 17years) due to neurological/neurodevelopmental disorders. In addition, other prominent companies such as Medytox, and GALDERMA, HUGEL, Inc. are focused on gaining a substantial share in the market in the forecast period. For instance, HUGEL, Inc. is focused toward launching their products in several European countries. Similarly, GALDERMA is focusing toward getting regulatory approvals for their product Dysport in China for the treatment of glabellar lines. These initiatives by the companies will help them maintain their presence in the global market. In terms of upcoming players, Revance Therapeutics Inc. is expected to play a prominent role on account of their pipeline candidate of DaxibotulinumtoxinA.


  • AbbVie Inc. (U.S.)

  • Ipsen Pharma (France)

  • Revance Therapeutics, Inc. (U.S.)

  • Merz Pharma (Germany)

  • Medytox (South Korea)

  • USWM, LLC. (U.S.)

  • GALDERMA (Switzerland)

  • Lanzhou Institute of Biological Products Co., Ltd. (China)

  • HUGEL, Inc. (Republic of Korea)


  • April 2022- Medytox Korea, a Medytox subsidiary, announced the completion of its Phase III trial for its next generation botulinum toxin (BTX), MBA-P01

  • February 2022 – HUGEL, Inc. announced that the company has received approval for their product, Letybo by the Austrian Federal Office for Safety in Health Care.

  • December 2021 – Daewoong Pharmaceutical Co., Ltd. announced that they submitted a Biologics License Application (BLA) to China’s National Medical Products Administration (NMPA) for their product (Nabota), used for the treatment of forehead wrinkles.

  • July 2021 - AbbVie, Inc. announced that they received approval from the U.S. FDA for the label expansion of BOTOX, which included eight new muscles for the treatment of upper limb spasticity in adults.

  • June 2021 - Medytox obtained marketing approval for their brand ‘meditoxin’, in Taiwan and is planning to expand further in South East countries. This will provide massive opportunities for Medytox and add a new customer base.


An Infographic Representation of Botulinum Toxin Market

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The global botulinum toxin market research report provides detailed market analysis and focuses on key aspects such as the overview of the number of procedures by key countries, overview of the types of these products, regulatory scenario by key countries, reimbursement scenario by key countries, and pipeline analysis. Additionally, it includes an overview of new product launches/approvals and the impact of COVID-19 on the global market, overview of application of these products in therapeutics and recent regulatory approvals and key industry developments. Besides these, the report offers insights into market trends and highlights key strategies by market players. In addition to the aforementioned factors, the report encompasses several factors that have contributed to the growth of the market in recent years.

Report Scope & Segmentation



Study Period


Base Year


Estimated Year


Forecast Period


Historical Period



Value (USD billion)


By Application, Type, End-user, and Region

By Application

  • Therapeutics

    • Chronic Migraine

    • Spasticity

    • Overactive Bladder

    • Cervical Dystonia

    • Blepharospasm

    • Others

  • Aesthetics

    • Forehead Wrinkles

    • Glabellar Lines

    • Crow's Feet

    • Others

By Type


  • Botulinum Toxin Type A

  • Botulinum Toxin Type B

By End-user

  • Specialty & Dermatology Clinics

  • Hospitals & Clinics

  • Others

By Region

  • North America (By Application, Type, End-user, and Country)

    • U.S. (By Application)

    • Canada (By Application)

  • Europe (By Application, Type, End-user, and Country)

    • U.K. (By Application)

    • Germany (By Application)

    • France (By Application)

    • Italy (By Application)

    • Spain (By Application)

    • Scandinavia (By Application)

    • Rest of Europe (By Application)

  • Asia Pacific (By Application, Type, End-user, and Country)

    • China (By Application)

    • Japan (By Application)

    • India (By Application)

    • Australia (By Application)

    • South Korea (By Application)

    • Southeast Asia (By Application)

    • Rest of Asia Pacific (By Application)

  • Latin America (By Application, Type, End-user, and Country)

    • Brazil (By Application)

    • Mexico (By Application)

    • Rest of Latin America (By Application)

  • Middle East & Africa (By Application, Type, End-user, and Country)

    • GCC (By Application)

    • South Africa (By Application)

    • Rest of Middle East & Africa (By Application)

Frequently Asked Questions

Fortune Business Insights says that the global market size was USD 6.13 billion in 2021 and is projected to reach USD 9.09 billion by 2029.

In 2021, market in North America stood at USD 4.04 billion.

Growing at a CAGR of 4.6%, the market will exhibit steady growth during the forecast period (2022-2029).

The therapeutics segment is expected to be the leading segment in this market during the forecast period.

Surge in demand for minimally-invasive cosmetic procedures and increasing R&D initiatives to gain regulatory approvals for newer cosmetic and therapeutic indications are the key factors that drive the market.

AbbVie Inc., Ipsen Pharma, and Merz Pharma are the top players in the market.

North America dominated the market in 2021.

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